Clinical Features and Treatment Outcomes in Patients with Choroidal Metastases

Abstract

Introduction: Choroidal metastasis is the most common intraocular malignancy, which causes visual loss and hence adversely affects patient's quality of life. External beam radiotherapy (RT) remains the treatment of choice. This retrospective study aimed to look at the treatment outcomes and clinical features in patients with choroidal metastases. Methods: It is a retrospective single-centre study. Patients with choroidal metastases diagnosed between 2006 and 2016 were identified from RT treatment database. Treatment outcomes after RT in terms of visual and objective response, median time to response were analysed. Clinical features regarding patients' demographics, cancer and ocular disease characteristics and survival were evaluated. Results: 21 patients with 28 involved eyes were identified. The median age at diagnosis of choroidal metastases was 55 years. The female-to-male ratio was 4:3. Bilateral choroidal metastases were found in seven (33%) patients. Concurrent or subsequent brain metastases were developed in eight (38%) patients. The most common symptom was blurring of vision (95%). The most common primary tumour type was lung carcinoma (n=9, 43%). The median survival was 5 months. The median prescribed biological effective dose was 39 Gy 10 (range, 28-39 Gy 10). Visual improvement was observed in 70% of irradiated eyes. Median time to visual improvement was 3.5 months (range, 2-5 months). Complete and partial remissions were achieved in nine (70%) eyes and two (15%) eyes, respectively. Conclusion: RT can effectively improve vision of patients with choroidal metastases. Prognosis in this group of patient remains poor.